Doctor Name: | MRS. AMANDA LEE DIXON |
NPI Number: | 1386905461 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 005162 |
Business Practice Address: | 21 Laurel Ave Cornwall, NY - 125181469 |
Business Phone Number: | 8452352267 |
Business Fax Number: | |
Mailing Address: | 495 Stanton Ter, POUGHKEEPSIE |
State: | NY |
Postal Code: | 126031164 |
Phone Number: | 8452352267 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2012 |
NPI Last Update Date: | 06/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 005162 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |